肝脏超声造影评估早期肝细胞癌病灶位置及术后转移价值研究  

Value of liver contrast-enhanced ultrasound in evaluating the location of early hepatocellular carcinoma and postoperative metastasis

作　　者：宋亿娣 Song Yidi(Department of Ultrasound,Tianjin Integrated Hospital of Traditional Chinese and Western Medicine(Tianjin Nankai Hospital),Tianjin 300250,China)

机构地区：[1]天津市中西医结合医院(天津市南开医院)超声科,300250

出　　处：《实用医学影像杂志》2024年第4期253-256,共4页Journal of Practical Medical Imaging

摘　　要：目的 探究肝脏超声造影(CEUS)在早期肝细胞癌(HCC)患者病灶位置及转移评估中的应用价值。方法 回顾性选取2021年1月至2024年1月本院收治的120例HCC患者(研究组)和120例乙型肝炎肝硬化患者(对照组)的临床资料,所有患者均接受增强CT、CEUS扫描。比较2组患者CEUS参数[峰值强度(PI)、达峰时间(TTP)、上升时间(RT)、渡越时间(mTT)],2种检查方法对HCC患者不同直径病灶的检出率及对HCC的诊断效能;对比CECT、CEUS对HCC患者术后转移病灶的检出情况。结果 研究组PI大于对照组,TTP、RT、MTT均短于对照组(P<0.05)。120例HCC患者中,CEUS分别检出最大径≥2 cm、<2 cm的病灶77个(58.8%)、54个(41.2%),增强CT分别检出77个(72.0%)、30个(28.0%);CEUS对直径<2 cm的病灶检出率高于增强CT(P<0.05)。以病理学检查诊断为金标准,CEUS诊断HCC的灵敏度为93.3%,高于增强CT的85.0%(P<0.05)。120例HCC患者中共52例患者(87个转移病灶)发生术后转移,受试者工作特征曲线(ROC)分析结果显示,CEUS诊断转移病灶的曲线下面积(AUC)(95%CI)为0.788(0.704,0.857),增强CT(95%CI)为0.737(0.649,0.813),CEUS诊断转移病灶的AUC大于增强CT(P<0.05)。结论 CEUS对早期HCC的诊断灵敏度较高,尤其适用于直径<2 cm的病灶;与增强CT比较,CEUS在评估术后转移病灶方面更具优势,具有较好的临床价值。Objective To explore the application value of liver contrast-enhanced ultrasound(CEUS)in evalu-ating the location and metastasis of early hepatocellular carcinoma(HCC).Methods The clinical data of 120 patients with HCC(study group)and 120 patients with hepatitis B cirrhosis(control group)who were admitted to the hospital from January 2021 to January 2024 were collected retrospectively.All patients underwent contrast-enhanced CT and CEUS scan.CEUS parameters peak intensity(PI),time to peak(TTP),rise time(RT)and mean transit time(mTT)of the two groups were comparatively analyzed.The detection rates of lesions of different diameters in patients with HCC,diagnostic performance for HCC,and detection of postoperative metastatic lesions in patients with HCC were compared between contrast-enhanced CT and CEUS.Results PI of the study group was greater than that of the control group.TTP,RT,and mTT were shorter than those of the control group(P<0.05).Among 120 patients with HCC,CEUS de-tected 77(58.8%)and 54(41.2%)lesions with a maximum diameter≥2 cm and<2 cm,respectively.contrast-en-hanced CT detected 77(72.0%)and 30(28.0%)lesions,respectively.The detection rate of lesions with a diameter smaller than 2 cm using CEUS was higher than contrast-enhanced CT(P<0.05).With pathological examination as the gold standard,the sensitivity of CEUS for diagnosing HCC(93.3%)was significantly higher than that of contrast-en-hanced CT(85.0%)(P<0.05).Among 120 patients with HCC,there were 52 patients with postoperative metastases(87 metastatic lesions).The receiver operating characteristic curve(ROC)analysis results showed that the area under the curve(AUC)(95%CI)values of CEUS and contrast-enhanced CT for diagnosing metastatic lesions were 0.788(0.704,0.857)and 0.737(0.649,0.813).The AUC of CEUS was greater than that of contrast-enhanced CT(P<0.05).Conclusion CEUS has high diagnostic sensitivity for early HCC,especially lesions with a diameter smaller than 2 cm.Compared with contrast-enhanced CT,CEUS has more advantages in evaluating pos

关 键 词：肝肿瘤 超声造影 增强CT 诊断 复发转移 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]